Does Girls' Sexual Debut Depend on Relationship with Mom?

Perry Wilson, MD, explores new study examining the link

A study appearing in the journal Pediatrics sheds light on the influence parent-child relationships have on the age of first sexual intercourse. In this 150-second analysis, MedPage Today clinical reviewer F. Perry Wilson, MD, channels Freud to clarify the results.

That your relationship with your parents could influence your sexual development is not exactly a new idea – paging Dr. Freud, right? Today, though, we'll be looking at some new data that gives us a more quantitative picture of what Sophocles tried to teach us 2,500 years ago in Oedipus Rex.

Before we dive in, though, I need to address the elephant in the room. Sexual exploration and even sexual intercourse are part of the normative development of adolescents. (I know, easy for me to say with my kids who are all 6 or under.) The primary outcome of this study, appearing in the journal Pediatrics, is "early sexual intercourse" – defined here as male-female insertional sex prior to the age of 16.

Why is that early? Well, because on average, teenagers have sexual intercourse a bit after 16 years of age.

So why do we care at all? Well, the data shows, perhaps not surprisingly, that kids who have sex at a younger age are more likely to engage in risky behaviors (like not using condoms), more likely to become pregnant, and more likely to contract a sexually transmitted infection. Maybe a few more years under the old belt would lead to better decision making all around.

The study examined just under 3,000 Dutch teenagers, followed over a four-year time span. At baseline – around 12 years old -- they were asked a series of questions focusing on their relationship with their mother and father. Questions like "Do you feel close to your mother?" and "Do you share your thoughts and feelings with your father?" Four years later, 16 years old now, they were asked if they had ever had sexual intercourse.

About 9% had over the intervening 4 years. Those who had "early" sex, in general, had worse relationships with both their mothers and fathers. But after accounting for family structure (basically, do you live with your biological parents or not), the only significant association that remained was a protective effect of the mother-daughter relationship.

That's right, when all is said and done, it's the relationship between mothers and daughters that influence early sexual activity in girls. Boys ... well it seems that nothing really moves that bar. This ... rings true to me.

The big problem with this type of study though, is something called social-desirability bias.

Kids are asked to rate their relationship with their parents. It's quite likely that some kids want to give the "right" answer here, regardless of what their relationship is truly like. And those kids may be less likely to have sex early. In other words, all of these results may be due to an "obedient child" effect.

But given the relatively low downside of encouraging strong parent-child relationships, I think we can give this a pass. As a dad, I'd love to help here, but according to this study, as with so much in the family: moms – it's up to you.

F. Perry Wilson, MD, MSCE, is an assistant professor of medicine at the Yale School of Medicine. He earned his BA from Harvard University, graduating with honors with a degree in biochemistry. He then attended Columbia College of Physicians and Surgeons in New York City. From there he moved to Philadelphia to complete his internal medicine residency and nephrology fellowship at the Hospital of the University of Pennsylvania. During his postgraduate years, he also obtained a Master of Science in Clinical Epidemiology from the University of Pennsylvania. He is an accomplished author of many scientific articles, and holds several NIH grants. He is a MedPage Today reviewer, and in addition to his video analyses, he authors a blog, The Methods Man. You can follow @methodsmanmd on Twitter.

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